Seeking transparency and wisdom in healthcare

Dec 05, 2018

Wisdom begins, we are told, first by fearing the Lord.

However, the next steps are considerably more worldly and could help tame our nearly insoluble health insurance difficulties. We think obtaining basic knowledge needed to make good life decisions for oneself and one’s family are vital. For instance, we are needful of hospitals and healthcare providers to publish pricing for their services, allowing consumers/patients to make intelligent economic decisions about their care and, in fact, their life.

Healthcare, which is still skyrocketing in cost in America, escapes the cost control and quality enhancement that competition provides in other segments of our economy. Providers don’t let people know the charge for, say, heart bypass surgery at one hospital by a certain surgeon so it can be compared to the price at another hospital by another surgeon.

Why?

According to James C. Capretta, who holds the Milton Friedman chair at the American Enterprise Institute, price transparency in health care does not exist because medical care isn’t bought and sold in a typical market.

So the challenge is to make it more typical.

“Because hospitals and physicians get so little of their revenue directly from consumers, they have no need to compete on price, and thus no need to make meaningful prices publicly available,” Capretta said. “Patients paid directly for only 11 percent of the services provided to them in 2016. Most of hospitals’ and physicians’ revenue comes from Medicare, Medicaid, and private insurance plans. When patients pay directly for care, it is often in the form of a copayment or a deductible that is unrelated to the total bill.”

We remain at a crossroads regarding our healthcare in America. Either people and families are going to start making informed decisions about the maintenance of their healthcare or the government, specifically the federal government, is going to make it those decision for them and taxpayers will foot the bill.

The gaggle of democratic socialists elected in 2018 are already calling for a single payer system, now popularly known as “Medicare for all,” as preached by Sen. Bernie Sanders. The plan would come at a huge cost to the nation – $32.6 trillion over 10 years.

And, as always, it’s not just the cost we worry about. It’s the quality.

People over 65 would be competing with all the young families in the country seeking care through the program that will slow immensely. Slow healthcare is bad or absent healthcare, especially for the elderly.

If you want to see how this healthcare would work, one doesn’t have to look at Canada or Great Britain. The Veterans Administration is an obvious and ongoing example of government provided medical care.

We don’t want to go there.

Transparent pricing is not the answer to all our problems but it provides a start down the road to controlling price and costs through the market rather than government fiat.

Alex Azar, secretary of Health and Human Services, knows this, according to Capretta, and is working to fix it.

“The goal should be to create understandable, standardized packages of medical care covering the most common problems and diagnoses. This kind of standardization will intensify competition among those providing services to patients because price differentials for essentially the same medical care will become visible to consumers,” he said.

Medicare is now testing payments based on bundled care packages, which are comparable provider to provider. With the bundled rate, government would take 3 percent off the traditional payment rate. Providers would then be able to keep whatever savings they can achieve within the remaining 97 percent of the payment.

Eventually, rather than the government setting the payment amount, providers would compete for the business by offering the bundles of care at varying prices in competition.

We hope this works before the nation fully buys into what is being talked about by the Left.

Competition makes for better services, especially compared to the bloat of single payer, in which people get more or less equally bad care at a cost that never declines.